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February 4, 2009

Many don’t get post-mastectomy radiation

by Sam Savage

Nineteen percent of women who should receive radiation after a mastectomy are not getting this potentially lifesaving treatment, U.S. researchers said.

Researchers at the University of Michigan Comprehensive Cancer Center in Ann Arbor looked at 396 women who were treated with a mastectomy for breast cancer and found that nearly one-fifth of women who fell clearly within guidelines recommending radiation treatment after the mastectomy did not receive the treatment.

Lead author Dr. Reshma Jagsi said that current guidelines recommend radiation after mastectomy for women who had particularly large tumors or cancer in four or more of their nearby lymph nodes.

There's an identifiable high-risk group for whom there's absolutely no debate -- they need radiation after their mastectomy, Jagsi said in a statement.

Even in this group for whom it's crystal clear, we found that only four-fifths were treated. That's not good enough. This is a potentially lifesaving treatment.

The study, published online ahead of print in the March 15 issue of the journal Cancer, found that the most common reason women cited for not considering radiation therapy was that it was not recommended by their doctors.

Much attention has been focused on educating people that they need radiation after lumpectomy, Jagsi said. "But many women assume having a mastectomy means radiation won't be needed. That's not always the case, and patients choosing one surgery over another hoping to avoid radiation need to be aware of this.